Medicaid: An Overview
Medicaid is a government health insurance program that provides coverage for low-income individuals and families. It is funded by state and federal governments and administered by states and territories. Medicaid provides coverage for a wide range of services, including hospitalizations, physician visits, lab tests, immunizations, prescription drugs, and more. It is a critical source of health coverage for more than 75 million people in the United States.
Background
Medicaid began in 1965 as part of the Social Security Act, which also created Medicare. Medicaid is a means-tested program, meaning that eligibility is based on income and other criteria. States must adhere to federal eligibility and coverage requirements, but they have the flexibility to design their own Medicaid programs within those guidelines.
Eligibility
To be eligible for Medicaid, individuals must meet certain income requirements. The federal poverty level (FPL) is used to determine eligibility. People who are below 133% of the FPL are eligible for Medicaid in most states, while people who are above the FPL may also qualify in some states. Eligibility for children is often based on family income and/or the age of the child. In addition to income requirements, states may also require applicants to meet other criteria, such as being a U.S. citizen or residing in the state.
Benefits
Medicaid covers a wide range of benefits, including primary and preventive care, hospitalizations, lab tests, prescription drugs, immunizations, and more. Many states also offer optional services, such as dental care, mental health services, and home health care. In addition, many states offer coverage for long-term care services, such as nursing home care.
Cost Sharing
Medicaid is a cost-sharing program. This means that states and the federal government divide the cost of providing care between them. States are responsible for paying a portion of the cost of care, while the federal government pays the remainder. Federal payments are based on a percentage of the state’s Medicaid spending, with the federal share ranging from 50% to 73%.
Conclusion
Medicaid is a critical source of health coverage for millions of low-income individuals and families in the United States. It provides coverage for a wide range of services, including hospitalizations, physician visits, lab tests, immunizations, and more. Eligibility is based on income and other criteria, and states and the federal government share the cost of providing care. Medicaid is an important part of the U.S. health care system and will continue to be so in the years to come.
References
Centers for Medicare & Medicaid Services. (2021). Medicaid. Retrieved from https://www.medicaid.gov/medicaid/index.html
Kaiser Family Foundation. (2021). Medicaid Eligibility. Retrieved from https://www.kff.org/medicaid/fact-sheet/medicaid-eligibility/
Kaiser Family Foundation. (2021). Medicaid Benefits. Retrieved from https://www.kff.org/medicaid/fact-sheet/medicaid-benefits/
Kaiser Family Foundation. (2021). Medicaid Financing. Retrieved from https://www.kff.org/medicaid/fact-sheet/medicaid-financing/